Outer Ear Infections
How do you know if you have an outer ear infection?
Outer ear infections usually begin with mild itching and a feeling of discomfort. This can progress rapidly resulting in severe pain, swelling of the ear canal and blockage. Sometimes there can be discharge which can have a pungent sweet odour. If untreated it can spread to involve the pinna and cheek.
With an outer ear infection pressing the tragus (the pointy bit in front of the ear canal) is painful.
This is in contrast to a middle ear infection where the pain is deep in the ear but there is no discomfort on touching the actual ear.
Patients with diabetes are at risk of a particularly aggressive form of otitis externa (malignant otitis externa) and should be treated urgently
How to treat an outer ear infection?
At an early stage antibiotic/steroid drops can be applied. If the canal is too swollen or there is too much debris and pus in the ear then the drops will not be able to get into the ear to work. In this situation the pus and debris will need to be cleared with microsuction and sometimes a sponge dressing is inserted into the ear to absorb the drops allowing them to work.
What can go wrong?
The infection may spread to involve the pinna (perichondritis) or the front of the cheek. This may not respond to topical oral antibiotics and admission to hospital for intravenous antibiotics may be necessary
Prevention
Otitis externa is usually brought on by trauma through the use of cotton buds or other imaginative objects used to clean the ear. Some patients have an increased tendency to develop repeated infections because they have an eczema type inflammation of the skin of the ear canal
Changes in humidity may cause infections and those patients who are prone to otitis externa should avoid getting water in the ear and may wish to have some customised swim mould made for their ears. Steroid drops and creams may also help stop patients from itching their ears
